Changes in body composition and muscle attenuation during taxane-based chemotherapy in patients with metastatic breast cancer

• Published in: Breast cancer research and treatment 2018-02, Vol.168 (1), p.95-105
• Main Authors: Rier, Hánah N., Jager, Agnes, Sleijfer, Stefan, van Rosmalen, Joost, Kock, Marc C. J. M., Levin, Mark-David
• Format: Article
• Language: English
• Subjects: 5-Fluorouracil; Adipose tissue; Adipose Tissue - diagnostic imaging; Adipose Tissue - drug effects; Adjuvant chemotherapy; Aged; Anthracycline; Anthracyclines; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Body composition; Body Composition - drug effects; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Cancer metastasis; Cancer patients; Cancer research; Care and treatment; Chemotherapy; Clinical Trial; Cyclophosphamide; Cyclophosphamide - adverse effects; Doxorubicin; Doxorubicin - adverse effects; Female; Fluorouracil; Fluorouracil - adverse effects; Humans; Medical prognosis; Medicine; Medicine & Public Health; Metastases; Metastasis; Middle Aged; Muscle, Skeletal - diagnostic imaging; Muscle, Skeletal - drug effects; Oncology; Paclitaxel; Paclitaxel - adverse effects; Physiological aspects; Prognosis; Skeletal muscle; Survival; Survival Analysis; Treatment Outcome; Wasting Syndrome - chemically induced; Wasting Syndrome - diagnostic imaging; Wasting Syndrome - epidemiology
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-017-4574-0

Purpose Body composition parameters including low muscle mass, muscle attenuation (which reflects muscle quality) and adipose tissue measurements have emerged as prognostic factors in cancer patients. However, knowledge regarding the possibility of excessive muscle loss during specific systemic therapies is unknown. We describe the changes in body composition and muscle attenuation (MA) during taxane- and anthracycline-based regimens and its association with overall survival (OS) in metastatic breast cancer patients. Methods The lumbar skeletal muscle index (LSMI) was used as marker of muscle mass. LSMI, MA, subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and intramuscular adipose tissue (IMAT) were measured before and after first-line treatment with paclitaxel ( n  = 73) or 5-fluorouracil-doxorubicin-cyclophosphamide (FAC) ( n  = 25) using CT-images. Determinants of the change of LSMI and MA were analyzed using multiple linear regression. OS was assessed using Cox proportional hazard models. Results MA significantly decreased during paclitaxel treatment (− 0.9 HU, p  = 0.03). LSMI ( p  = 0.40), SAT ( p  = 0.75), VAT ( p  = 0.84) and IMAT ( p  = 0.10) remained stable. No significant alterations in body composition parameters during FAC-treatment were observed. Previous (neo-)adjuvant chemotherapy contributed to larger loss of MA during the current treatment. Body composition changes during chemotherapy were not associated with OS. Conclusions MA decreased during treatment with paclitaxel, while muscle mass was stable. Body composition changes are not associated with survival in the absence of progressive disease.